Provider Demographics
NPI:1801110036
Name:EVOLVE COUNSELING SERVICES, INC.
Entity type:Organization
Organization Name:EVOLVE COUNSELING SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:AUDREY
Authorized Official - Middle Name:L
Authorized Official - Last Name:PEPPERS
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:217-328-2551
Mailing Address - Street 1:1606 WILLOW VIEW RD
Mailing Address - Street 2:SUITE 2J-1
Mailing Address - City:URBANA
Mailing Address - State:IL
Mailing Address - Zip Code:61802-7475
Mailing Address - Country:US
Mailing Address - Phone:217-328-2551
Mailing Address - Fax:217-328-2997
Practice Address - Street 1:1606 N WILLOWVIEW RD
Practice Address - Street 2:SUITE 2J-1
Practice Address - City:URBANA
Practice Address - State:IL
Practice Address - Zip Code:61802-7446
Practice Address - Country:US
Practice Address - Phone:217-328-2551
Practice Address - Fax:217-328-2997
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-17
Last Update Date:2010-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health